Increased blood volume, added weight and other pregnancy-related changes may lead to minor, though annoying, pains. Don’t reach for painkillers, which may not be safe for your unborn baby.

Backache

Backaches often occur as your increasing weight pulls your spine forward and shifts your center of gravity. Here’s what to do:

• First, consider the possibility of backache as a symptom of preterm labor.
• Practice good posture. Tuck your buttocks under and stand straight and tall.
• Be careful when lifting objects. Bend your knees instead of bending over. Use leg muscles instead of back muscles to push yourself upward.
• Wear supportive shoes with low heels.
• Avoid standing for long periods of time. Put one foot on a stepstool to relieve back stress while standing.
• Exercise at least three times a week (for example, swim, walk or stretch).
• Join a prenatal exercise or yoga class.
• Do pelvic tilt exercises to reduce discomfort.
• Wear a maternity support belt or maternity pants with a low, supportive waistband.
• Apply heat using warm bath soaks, warm wet towels, a hot water bottle or heating pad.
• Get a back massage.
• Rest.
• If the pain continues, ask your healthcare provider for a referral to a physical therapist.
• Avoid medications. No medications are considered 100 percent safe during pregnancy. Aspirin and other painkillers, such as ibuprofen, may be harmful to your baby. Ask your healthcare provider about medication to treat backache.

Headache

The increased blood volume and hormonal changes of pregnancy may cause headaches. Stuffy nose, fatigue, eyestrain, anxiety or tension may also increase headache frequency.

For relief:

• Try to determine what triggers your headaches, such as coffee, cigarette smoke, stuffy rooms, fluorescent lights or eyestrain, and avoid them whenever possible.
• Apply a cool, wet washcloth or ice pack to your forehead and the back of your neck. (A warm cloth works better for some people.)
• Try to get plenty of sleep every night, and rest during the day when possible.
• Try to eat something every two to three hours.
• Drink plenty of liquids.
• Take a warm shower or relaxing bath.
• Massage your neck, shoulders, face and scalp, or ask a friend to give you a massage.
• Try to find a quiet, dimly lit place to relax.
• Get some fresh air or take a walk.
• Use relaxation, meditation and self-hypnosis techniques.

If you have headaches that are severe, frequent, long lasting or accompanied by blurred vision, spots, lights flashing or swelling, contact your doctor immediately. These symptoms may indicate preeclampsia, a dangerous condition.

Avoid all headache medications until you talk to your healthcare provider. No painkiller is considered 100 percent safe. Painkillers, such as aspirin and ibuprofen, may be harmful if taken during pregnancy. Aspirin taken in the last three months of pregnancy may increase your risk of bleeding.

Lower Abdominal and Pelvic Pain

During pregnancy, the pelvic joints relax in order to increase the size and flexibility of the pelvis before giving birth. This may cause pressure on the sciatic nerve and lead to pain in the pelvic area, down the thigh and into the leg.

At times, a discomfort known as “round ligament pain” can take your breath away. You may be walking and suddenly feel a “knife-stabbing” pain on one or both sides of your lower abdomen or groin. Or you may feel a spasm in your vagina or rectum. As quickly as it came on, it may go away. Ligaments hold the uterus in place, one on either side and a third going across the pelvic floor. As your uterus grows, these ligaments stretch like a rubber band. Any sudden movement or position change can cause them to spasm.

For relief:

• Apply a heating pad, hot water bottle or ice pack to the painful area.
• Get a gentle massage.
• Experiment with different sleeping positions. Try sleeping on your side, with one leg forward supported on a pillow and the other back, as if you were running.
• Use proper body mechanics when lifting, bending and stretching during your pregnancy and after you deliver.
• Practice the pelvic tilt exercise.
• Wear a maternity support belt to help relieve pressure.

Call your doctor or clinician immediately if your abdominal pain continues or becomes stronger as time goes on. If you cannot contact your healthcare provider, go to the hospital.

Muscle Cramps

Possible causes of common muscle cramps include a calcium imbalance, pointing your toes when you stretch and decreased circulation in your legs.

To prevent muscle cramps:

• Be sure to include enough calcium (1,000 mg per day) in your diet from dairy products (3-4 glasses of milk a day) or nondairy sources such as enriched tofu, molasses and dark green leafy vegetables.
• Exercise to increase the circulation in your legs.
• Elevate your legs as often as possible.
• Keep your legs warm.
• Take a warm bath before you go to bed.
• Don’t point your toes when you stretch. Instead, flex your feet by pulling your toes toward your knees.
• Avoid lying on your back, which decreases circulation to your legs.
• Loosen the bedding at the foot of your bed.
• Before going to bed, stretch your calf muscles by doing leg lunges: stand with one foot well in front of the other, with your back leg straight and heel flat. Gradually bend your front leg at the knee and lean forward. Hold for a few seconds and repeat. Then switch legs.

If you get a cramp:

• Sit on the floor with your legs straight (do not lock your knees) and flex your toes towards your knees. You can accomplish the same thing by sitting on the floor and putting a long towel, scarf or elastic exercise band around the ball of your foot. Hold both ends of the towel or scarf and gently pull it towards your body.
• Massage the cramped muscles or apply an ice pack.
• When you can, stand up and walk around.
• Soak your cramped muscles in warm water, or use a heating pad or hot-water bottle.
• Avoid all medicines for leg cramps. There are no safe medications you can take for leg cramps during a pregnancy.

If these suggestions don’t work, consult your doctor.

Nosebleeds and Bleeding Gums

Some women get nosebleeds during pregnancy because increased blood volume causes nasal membranes to swell. Additionally, increased hormone levels and low vitamin C levels may cause tenderness, swelling and bleeding in your gums.

Don’t panic, and use these measures:

• During a nosebleed, lie down and apply pressure and cold compresses to your nose.
• Use a humidifier if the air in your home tends to be very dry.
• Try a thin coating of petroleum jelly in each nostril, especially at bedtime.
• Continue practicing good oral hygiene.
• Make sure you’re getting enough vitamin C the foods you eat. However, avoid taking too many vitamin supplements. Ask your healthcare provider for recommendations.